Do you love snacking on nuts but worry about having an allergic reaction?
Tree nut allergies are becoming increasingly common, and hazelnuts are one of the most common culprits. But can you be allergic to hazelnuts and not other nuts?
The answer is not so straightforward. In this article, we will explore the complexities of tree nut allergies and provide you with the information you need to stay safe and healthy.
So, grab a cup of coffee and let’s dive in!
Can You Be Allergic To Hazelnuts But Not Other Nuts
The short answer is yes, it is possible to be allergic to hazelnuts but not other nuts. However, it is important to understand that tree nut allergies are complex and can vary from person to person.
According to research, co-sensitivities are most likely to be found in cashews and pistachios from the Anacardiaceae family and walnuts and pecans from the Juglandaceae family. This means that if you are allergic to one type of nut in these families, you may also be allergic to other nuts in the same family.
However, allergies to tree nuts such as hazelnuts are common and often severe. These types of allergies typically develop by the age of 2, and the number of tree nuts to which a person is allergic may increase with age. Roughly 30 percent of people with a tree nut allergy are allergic to more than one nut.
It is also important to note that peanuts are not actually tree nuts, but legumes. However, approximately 20 to 30 percent of those with a peanut allergy are also allergic to one or more types of tree nuts.
So, while it is possible to be allergic to hazelnuts but not other nuts, it is important to get tested by an allergist to determine which specific tree nuts you are allergic to. Allergists will interpret allergy test results in the context of the clinical picture – what happened when those nuts were eaten. If a person has a positive test result but has been able to tolerate a type of nut without symptoms, then the result is likely a false positive.
Understanding Tree Nut Allergies
Tree nut allergies are one of the most common food allergies in both adults and children. Allergic reactions to tree nuts can range from mild symptoms such as minor itching, watery eyes, and a scratchy throat to life-threatening anaphylaxis. Some of the most common tree nuts that people are allergic to include walnuts, almonds, pistachios, cashews, pecans, hazelnuts, macadamias, Brazil nuts, and pine nuts.
It is important to note that people can be allergic to one type of tree nut or several. Being allergic to one type increases the risk of being allergic to others. In fact, roughly 30 percent of people with a tree nut allergy are allergic to more than one nut.
Tree nut allergies typically develop by the age of 2 and may increase in number with age. Unfortunately, compared to other food allergies, the chances of outgrowing these allergies are lower and restricted to an estimated 10 percent of sensitized individuals.
It is also important to understand that tree nuts from the same family often cause cross-reactivity between each other. For example, people who are allergic to walnuts are more likely to be allergic to pecans because they come from the same tree nut family. On the other hand, people who can tolerate walnut are more likely to tolerate pecan.
If you suspect that you may have a tree nut allergy, it is crucial to get tested by an allergist to determine which specific tree nuts you are allergic to. Allergists may consider supervised oral food challenges for tree nuts that test low or negative but have never been eaten before. However, some allergists recommend avoidance of all tree nuts in patients with an allergy to any nut or nuts because of the risk of cross-contact among nuts during the manufacturing process.
What Makes Hazelnuts Different?
Hazelnuts are one of the most common tree nuts and are often found in pastries, chocolates, and nut butters such as Nutella. Despite their uses, hazelnuts are the most common tree nut allergy in Europe. In the United States, Western Europe, and Australia, prevalence of hazelnut allergy is 7.2 percent (including those with birch pollen sensitivity) according to one study.
Hazelnut allergy is also unique in that it is commonly associated with oral allergy syndrome. This syndrome causes people who are allergic to pollen to react to other substances like hazelnuts. Reactions to oral allergy syndrome are typically mild. However, for people who are specifically highly sensitive to the allergen in hazelnuts, there is a risk of more severe reactions, including anaphylaxis which is a medical emergency.
It is also important to note that hazelnut allergy can develop at any age, but it is more common for reactions to start in childhood. The risk is greater if there is a family history of hazelnut allergy or if the person has an allergic condition like severe eczema.
Cross-Reactivity And Other Nut Allergies
Cross-reactivity is a phenomenon that occurs when the proteins in one type of food trigger an allergic reaction in someone who is allergic to another food. For example, if someone is allergic to birch pollen, they may also experience an allergic reaction to hazelnuts due to the similarity of the proteins in both substances. This is known as Oral Allergy Syndrome (OAS) or pollen-food syndrome (PFS).
Hazelnuts represent the main culprit of nut allergy in Europe, while walnut and cashew are more common in the USA, and Brazil nut, almond, and walnut are more common in the UK. The estimated prevalence of hazelnut allergy in Italy and Europe is around 0.2%. The high frequency of hazelnut allergy in Italy could be justified by its high consumption rate, considered the highest in the world.
Allergy to hazelnuts is an IgE-mediated hypersensitivity reaction induced by nut proteins, occurring within a few minutes from ingestion. Two clinical pictures of hazelnut-induced IgE-mediated reactions have been described. Primary hazelnut allergy, frequently characterized by generalized systemic and often severe reactions, potentially life-threatening, occurring immediately after hazelnut consumption, is due to IgE against specific major hazelnut allergens. It is more prevalent in children younger than five years. Severe generalized allergic reactions may be characterized by respiratory (rhinitis and/or asthma), gastrointestinal (abdominal pain, vomiting or diarrhea), and cardiovascular symptoms (tachycardia, hypotension, shock).
On the other hand, OAS manifests with mild symptoms limited to the oropharynx, characterized by itching or burning of the tongue and oral mucosa, and rarely related to anaphylaxis. PFS is typically seen in adolescents and adults with a history of seasonal allergic rhinitis.
It is important to note that while it is possible to be allergic to hazelnuts but not other nuts, cross-reactivity can occur between different types of nuts and other foods. Therefore, it is essential to get tested by an allergist to determine which specific tree nuts you are allergic to and to avoid all foods that trigger an allergic reaction.
Symptoms Of A Hazelnut Allergy
If you are allergic to hazelnuts, you may experience a range of symptoms that can vary in severity. The most common symptoms of a hazelnut allergy include itching of the mouth, throat, eyes, skin, or any other area. You may also experience swelling of the lips, mouth, tongue, or throat, as well as hives on the mouth.
In some cases, a hazelnut allergy can cause more severe symptoms such as difficulty breathing, wheezing, chest tightness, and anaphylaxis. Anaphylaxis is a severe and potentially life-threatening reaction that can cause a drop in blood pressure and loss of consciousness.
If you experience any of these symptoms after eating hazelnuts or any food containing hazelnuts, seek medical attention immediately. Anaphylaxis requires immediate treatment with epinephrine (adrenaline) to prevent serious complications.
It is also important to note that some people with a hazelnut allergy may experience symptoms when eating other seemingly unrelated foods. This is called cross-reactivity and occurs when your body’s immune system identifies the proteins in different substances as being structurally similar or biologically related, thus triggering a response. The most common cross-reactivities with hazelnuts are plant foods, such as tree nuts, fruits, soybeans, vegetables, and legumes.
If you experience an itchy mouth or ears, scratchy throat, hives on the mouth, or swelling of the lips, mouth, tongue, or throat after eating hazelnuts or other related fresh fruits, raw vegetables, or tree nuts, you may suffer from pollen food allergy syndrome (PFAS) also called oral allergy syndrome (OAS). This condition is caused by your immune system’s reaction to similar proteins found in foods and pollens.
Diagnosis And Treatment Options
If you suspect that you may have a hazelnut allergy, it is important to get a proper diagnosis from an allergist. The diagnostic process usually involves a combination of a physical examination, a review of your medical history, and allergy testing.
Allergy testing can include skin prick tests or blood tests to determine whether you have an allergic reaction to hazelnuts. Component-resolved diagnosis (CRD) is another type of allergy testing that can be used to identify specific proteins in hazelnuts that are responsible for triggering an allergic reaction.
If you are diagnosed with a hazelnut allergy, the only way to avoid a reaction is to avoid eating hazelnuts. Hazelnuts are one of the eight most common food allergies in the United States and are covered by current food allergy labeling laws. Food manufacturers are required to list nuts on their ingredient labels in plain English, which makes it easier to avoid them in packaged foods.
If you are prone to anaphylactic reactions, your healthcare provider will likely prescribe an epinephrine auto-injector such as EpiPen. You will need to carry your auto-injector with you at all times so that it’s always available in case you have a severe reaction.
Currently, there is no definitive treatment for hazelnut allergy. Hazelnut-free diets and emergency management of symptoms, including the use of auto-injectable epinephrine, still represent the main approach. Oral allergen immunotherapy (AIT) appears to be a promising therapeutic strategy for treating hazelnut allergies in the future.
Managing Hazelnut Allergies In Daily Life
If you have been diagnosed with a hazelnut allergy, it is important to manage it in your daily life to avoid any severe reactions. Here are some tips for managing hazelnut allergies:
1. Avoid eating hazelnuts: The only way to avoid a reaction is to avoid eating hazelnuts. Hazelnuts are often found in pastries and chocolates as well as in nut butters such as Nutella. Make sure to read ingredient labels carefully and avoid any foods that contain hazelnuts.
2. Be aware of cross-contamination: Hazelnuts can be easily cross-contaminated with other nuts during processing or packaging. Make sure to avoid any foods that may have come into contact with hazelnuts.
3. Carry an epinephrine auto-injector: If you are prone to an anaphylactic reaction, your healthcare provider will prescribe an epinephrine auto-injector (commonly referred to by the brand name EpiPen). You will need to carry your auto-injector with you at all times so that it’s always available in case you have a severe reaction.
4. Talk to your friends and family: Make sure your friends and family are aware of your hazelnut allergy and know how to respond in case of an emergency.
5. Be cautious when eating out: When eating out, make sure to inform the restaurant staff about your hazelnut allergy and ask about the ingredients used in the dishes you are interested in.
6. Educate yourself: Learn as much as you can about hazelnut allergies and how to manage them. This will help you make informed decisions about what foods to eat and how to respond in case of an emergency.
In conclusion, managing a hazelnut allergy requires careful attention and planning. By avoiding hazelnuts, being aware of cross-contamination, carrying an epinephrine auto-injector, talking to your friends and family, being cautious when eating out, and educating yourself, you can reduce the risk of a severe reaction and live a healthy and happy life.
